The FY27 federal budget proposal is officially out, and while it’s just the opening move, there’s already a lot to unpack. In this episode, ASTHO’s Senior Director for Government Affairs, Jeffrey Ekoma, breaks down what’s in the proposal, what’s changed from last year, and what it all signals for public health and federal agencies. He’ll dig into key highlights, including the proposed creation of the Administration for a Healthy America (AHA), new structural changes within HHS, and fresh initiatives at the CDC and FDA, from data reporting requirements to food safety oversight. Jeffrey also explains how this year’s proposal compares to previous budgets, where cuts and consolidations stand, and why states may be asked to take on more responsibility.
The FY27 federal budget proposal is officially out, and while it’s just the opening move, there’s already a lot to unpack. In this episode, ASTHO’s Senior Director for Government Affairs, Jeffrey Ekoma, breaks down what’s in the proposal, what’s changed from last year, and what it all signals for public health and federal agencies. He’ll dig into key highlights, including the proposed creation of the Administration for a Healthy America (AHA), new structural changes within HHS, and fresh initiatives at the CDC and FDA, from data reporting requirements to food safety oversight. Jeffrey also explains how this year’s proposal compares to previous budgets, where cuts and consolidations stand, and why states may be asked to take on more responsibility.
President Trump Releases FY27 Budget Proposal: April 2026 | ASTHO
RSV is still spreading, prompting states to extend the immunization period | CNN
John Sheehan (0:00): This is Public Health Review Morning Edition for Friday, 04/10/2026. I'm John Sheehan with news from the Association of State and Territorial Health Officials. On today's View from Washington, D. C, breaking down the President's FY twenty seven budget proposal. Jeffrey Acoma, ASTHO's senior director for government affairs, joins us to discuss what's in the proposal, what's changed from last year, and what it all signals for public health and federal agencies.
John Sheehan (0:25): He'll dig into key highlights, explain how this proposal compares to previous budgets, and what new legislative items have his attention. Jeffrey Coma, welcome back to the show.
Jeffrey Ekoma(0:36): Thank you. So glad to be back.
John Sheehan (0:37): So, Jeffrey, when last we talked, the budget proposal for FY '27 was imminent, and it has been released. So what should people know?
Jeffrey Ekoma (0:48): John, the budget was released. Actually released on April 3. We actually released a comprehensive legislative alert that delves into the budget. We hope that folks will take some time to go through it if you're interested. While we expected budget overviews or budget and briefs for agencies to be the only documents released, We also receive congressional justification documents for operating divisions that go more in-depth into each of the different operating divisions.
Jeffrey Acoma (1:17): Now, in theory, the lease of the president's budget kicks off the appropriations process. However, as I've mentioned in the past, there have been appropriations related activity in both chambers of Congress already. So this sort of joins the train that's already been going a 100 miles an hour so far.
John Sheehan (1:34): Okay. And so how does this proposal compare to the previous years and, like, what are the big shifts?
Jeffrey Ekoma(1:41): Yeah. Before getting into that, it's important to remember that the president's budget is a proposal to congress and congress has the ability to accept, reject, or modify the budget as they retain the power of the purse. Much of the budget was similar to the budget last year and included similar program eliminations, consolidations, and reorganizations. Much of the cuts were not as large as they were last year. The budget again proposed the establishment of the Administration for Healthy America or and reflects a planned reorganization across HHS as part of the proposal.
Jeffrey Ekoma (2:19): It also proposes the establishment of a new National Center for Chemicals and Toxins within CDC and a new $300,000,000 grant program that would consolidate hepatitis, STI, and tuberculosis grant funding into one program. Unlike the new National Center for Chemicals and Toxins, the proposal on hepatitis, STI, and tuberculosis was included in last year's budget. So you'll see there's some things that are similar and some things that are different. Also similar to last year was an interest in states taking on more responsibility for the funding of various programs such as preparedness and water infrastructure projects to name a few.
John Sheehan (2:59): Yeah. And to your point, every administration will put out their proposals for a budget, you know, and it's up to congress ultimately. It's more like a wish list of what the president or this the current administration wants to see happen, but it never ever goes exactly according to that.
Jeffrey Ekoma(3:18): Never does.
John Sheehan (3:19): Okay. So with that in mind, were there any new proposals or provisions in the budget that were eye catching or, you know, really took you by surprise?
Jeffrey Ekoma (3:30): There were a couple that caught my attention. Within CDC, there's a proposal that will allow CDC to set data reporting requirements to improve data reporting from health care providers to public health authorities. And another one that caught my attention would allow the agency to convert fellowship and training program appointments to long term or permanent positions within CDC. Within FDA, there were several proposals that ranged from strengthening oversight of foods to better protect the health of children to amending statute to authorize the FDA to share food safety information with state, local, tribal, and territorial jurisdictions. So lots of legislative proposals.
Jeffrey Ekoma (4:13): We cover all of them in our legislative alert.
John Sheehan (4:16): Yeah. That's some serious motion as as usual.
Jeffrey Acoma (4:19): Yeah. Lots of lots of things to be to look into and things that I'm sure will catch the attention of appropriators on Capitol Hill.
John Sheehan (4:27): And as you're keeping an eye on those changes, are there things to expect over the next few weeks that you're also anticipating? Secretary Kennedy will be testifying.
Jeffrey Acoma (4:36): Yeah. Absolutely. The secretary is scheduled to testify before six committees in the coming weeks, including the House and Senate Appropriations Committees, Senate Help and Finance Committees, the House Energy and Commerce Committee, as well as the House Ways and Means Committee. So he has a lot on this to do on Capitol Hill in the coming weeks. We will be actively monitoring those hearings, and we look forward to providing an update on them in the future.
John Sheehan (5:03): Yeah. We'll have you back.
Jeffrey Ekoma (5:04): Can't wait to be back to talk about those hearings.
John Sheehan(5:06): Alright. Thanks a lot, Jeffrey.
Jeffrey Ekoma (5:07): Appreciate it. Thank you.
John Sheehan (5:08): Jeffrey Acoma is ASTHO's senior director for government affairs. To get more up to date news and updates on federal activity in Washington, subscribe to ASTHO's legislative alerts. For more than eighty years, ASTHO has championed public health and supported work of state and territorial health agencies across the nation. So stay ahead of the curve on emerging health policy trends and legislative developments at both the state and federal levels, and get timely updates delivered directly to your inbox. The link is in the show notes.
John Sheehan (5:39): In recent national news, CNN interviewed ASTHO Chief Medical Officer Susan Kansagra and ASTHO member and Washington State Health Officer Doctor. Dao Shan Quan Gett about the ongoing spread of RSV. Find the link to the CNN article titled RSV is Prompting States to Extend the Immunization Period in the show notes. This has been Public Health Review Morning Edition. I'm John Sheehan for the Association of State and Territorial Health Officials.
